Modifications of preputial unfurling to reduce postoperative edema in buried penis.
OBJECTIVE
Buried penis is a result of penile skin deficiency and inadequate attachment of the skin to the Buck's fascia. Prolonged postoperative edema (>1 month) has been seen in some patients after preputial unfurling. Some modifications which may reduce this complication are described.


METHODS
Thirty-two boys with buried penis, aged 14 months to 12 years, underwent the surgical procedure. A circumferential incision was made at the junction of the outer and inner prepuce. The subcutaneous tissue was removed from the inner prepuce and degloved from the Buck's fascia, so that a thin inner prepuce could be sutured directly to Buck's fascia. Excessive prepuce was trimmed. Reapproximation of the outer and the inner prepuce completed the procedure. A narrow skin ring at the penile base, which may compromise venous and lymphatic flow, was avoided by dorsal or ventral incision.


RESULTS
Mild edema was seen in some patients but subsided within a month. Satisfactory cosmetic results were achieved.


CONCLUSIONS
This procedure unfurls the inner prepuce to cover the penile shaft. Ideal cosmetic results can be achieved if some details of the procedure are emphasized.
Chin
Taiwai
T
Division of Pediatric Surgery, Children's Medical Center, Veterans General Hospital-Taipei, 201, Shih Pai Road, National Yangming University, Taipei, Taiwan 11217, R.O.C. twchin@vghtpe.gov.tw
Tsai
Hsinlin
H
Liu
Chinsu
C
Wei
Choufu
C